COVID-19: Here to Stay?
Aimée Look, Investigative Journalist
December 5, 2021
While Canada rolled out vaccine doses for my university-age peers in early June, those under 30 had barely started receiving the vaccine in the UK.
I was desperate to get vaccinated as well, seeing that it was required to have both doses before I returned to school in the Fall. I thought that if I couldn’t get the vaccine, maybe I could help speed up the process by volunteering.
The Heathrow Airport Mass Vaccination Center in London was an extraordinary, multi-level operation, with the entire building functioning like a well-oiled machine. Nurses and pharmacists organized the NHS digital system, prepared vaccines and supervised patients.
Most of the people administering Pfizer doses were flight attendants for British Airways, taking the role temporarily as demand for flights slowed and vaccines took off. They were perfectly suited to the role of a vaccinator and made all the nervous patients feel at ease.
I finally received a left-over Pfizer jab at the end of a shift, and never felt more excited for a vaccine in my life. The three-inch business card was proof of freedom, protection for me and my family. It seemed like, for me at least, Covid was “over”.
This week, a close friend of mine contracted COVID-19, after receiving two vaccines this summer. After finally feeling like I had regained a sense of normalcy, I wondered how this could be possible if I was going to get infected and why cases were rising again.
I brought my questions to Dr. Richard Hatchett, the CEO of CEPI (Coalition for Epidemic Preparedness), a global organization that develops and distributes vaccines to prevent future epidemics. Dr. Hatchett has immense experience in pandemic countermeasure programs, in the White House under Presidents George W. Bush and Barack Obama.
According to Dr. Hatchett, as with any vaccination, the COVID-19 vaccine has a certain degree of protection, around 90-95% effective—which is what the Pfizer and Moderna vaccines initially had.
However, from that level of effectiveness, an individual’s immune response wanes over time, as do their antibody levels. Dr. Hatchett explained that the way our immune system works is twofold; we have an immune response that protects against severe disease and one that protects against less severe infections, and the response can be separate.
“COVID seems to be a disease where the immunity provided by the vaccine allows a high degree of protection against severe disease or death, but over time provides decreasing protection against reinfection. The vast majority of infections occurring after vaccination are essentially pretty mild.”
Many countries have begun recommending boosters, as protection declines over time and can be restored by a third shot. However, Dr. Hatchett explains one thing is unclear: whether COVID-19 is a disease where boosters will be required every 6-12 months to sustain protection, or a disease like Hepatitis B, where durable immunity can be achieved after multiple doses are administered over 6-12 months.
Initially, the vaccines were tested with short intervals between the first and second dose, and there was not enough testing done to initially understand an optimal testing schedule. So, we are finding out in “real-time” what the best intervals between vaccines are.
Alternatively, he explains it could be a disease like influenza where the virus continues to evolve, and immunity needs to be “renewed” with an annual influenza shot. The influenza vaccine needs to be updated periodically as the circulating virus changes, and over time we may find out that COVID is the same. The development of new drugs and treatments definitely may improve the ongoing situation, but there is the potential for the virus to rapidly mutate in response.
So far, we know that after two doses, susceptibility to COVID increases over time, but the booster can reduce the incidence after infection. Everything else about the COVID vaccine is still trying to be understood by governments and health professionals.
Especially in Europe, governments have begun to re-implement countermeasures in an effort to slow the continual spread of COVID-19. According to Dr. Hatchett, different countries are all having completely different experiences with vaccination programs, and there is no way to make a broad overarching statement or prediction about the future.
For example, in the UK there are geographic pockets of anti-vaccination sentiments, areas where people are unvaccinated. Among older people or those at severe risk, vaccination rates are quite high- usually the younger demographic are resistant to getting the vaccines in the UK. Despite a high case burden, the UK is facing proportionally lower hospitalizations and a lower death rate.
According to Dr. Hatchett, the US faces a completely different set of issues. There are high degrees of political and geographic polarization for acceptance of countermeasures and masks. There are areas with resistance to masks, and vaccines, so consequently when the viral transmission goes up, there are higher rates in those areas. In the UK, the vaccine for the most part has been embraced, unlike in the US where large areas have been resistant.
Society is also separated between resistors and the government in Europe, especially in Austria and Germany where we are seeing high rates of the population being unvaccinated, for example around ⅓ in Germany. However, each country in Europe has its own manifestation of anti-countermeasure sentiments, so it is difficult to make a complete generalization.
The use of non-pharmaceutical interventions and strategies discriminating against unvaccinated is a Public Health rationale to reduce transmission, reduce the burden of cases and reduce the number of deaths.
Early in the pandemic, these measures worked but were associated with a high social cost and had elicited a lot of resistance from the people in the form of protests. In the last few days, anti-countermeasure protests have become violent in many places in Europe, for example in the Netherlands, Germany and Austria. These polarizing measures will not work unless society embraces them.
Dr. Hatchett referenced South Korea as an example of a country that has fully embraced and controlled the virus remarkably well overall, despite a recent uptick in cases.
“After experiencing an outbreak of another coronavirus MERS in 2015, there was a small outbreak despite a drastic decrease in tourism and heavy economic impact on society.
The MERS outbreak really sensitized their government to the dangers of disease outbreaks, and when they were hit by COVID-19 in 2020, they emphasized aggressive testing and outbreak tracing.
Asian cultures are much more acclimated to wearing masks to prevent disease transmission, and it has become a prevalent social norm since the SARS and MERS epidemics. As the population was used to doing this, they had more confidence in their government using interventions.
Korea has mounted a really aggressive effort to reduce transmission, test and trace, without huge draconian lockdowns.”
South Korea’s government had an appropriate and early public health response, so they were able to keep society open and the economy functioning well. Their population properly understands why such countermeasures are implemented.
Compared to many Asian countries, the West was slow in taking the threat of COVID-19 seriously. Dr. Hatchett explains how, in Western countries, it seems that public health or economic priorities are a zero-sum game and pitted against each other. This isn’t necessarily true; South Korea has been implementing measures yet not taking enormous economic hits. The number of cases and deaths in Korea is extremely low, and measures are not seen as a cap on freedom.
But, will COVID-19 ever go away? Dr. Hatchett says it won’t ever “go away,” but we will find a new equilibrium to open up and get back to normal life.
Around 100 people a day are dying in the UK from COVID-19, and around 1000 in the US, so we still need to work to suppress the spread of the virus by getting vaccinated and taking precautions. As boosters become more available and more research on vaccine effectiveness is understood, the virus might be transformed, analogous to the way that HIV has been transformed from something deadly to more manageable.
If it’s never going away, where will things settle out? Dr. Hatchett suspects that we will be getting “COVID-19 weather reports” from now on, and hearing about what the latest recommendations for vaccines are. High-risk groups might still need to modify their behaviour, and rapid tests and treatments are being more commonly rolled out to prevent the spread.
It might have been naive of me to assume “Covid is over!” when I became fully vaccinated. We need to recognize that vaccinations are a vital step towards normalcy, as is keeping yourself accountable for stopping the spread. Perhaps, instead of hoping that the Covid will end, we can instead work towards eliminating all of the fear and risk that has been associated with the pandemic.
By working with the government and acclimating to small changes, living with the virus might be something that we get used to—even if it is our ‘new normal’.